Am J Clin Microbiol Antimicrob | Volume 6, Issue 1 | Case Report | Open Access

First Case of VAD-Associated Mediastinitis by Gordonia bronchialis: A Case Report and a Review of an Emergent Pathogen

Calderón AT1,2*, Cobo RT3, Levine MB4, Cobo M1, Castrillo C1, Burgos V1, Ruiz-Lera M1, Eduardo-Luján1, Olavarri I1, Royuela N1, Vilchez FG1,2, Cardenal ML1, Villar CR1,2, Nistal Herrera JF5, Quevedo VT5, Sarralde Aguayo JA5, Cuadra MG6, Fariñas Álvarez MDC6, de la Torre Hernández JM1,2 and Álvarez AC1

1Department of Cardiology, Marqués de Valdecilla University Hospital, Spain 2Cardiovascular Research Group, Instituto de Investigación Valdecilla (IDIVAL), Spain 3Service of Internal Medicine, Hospital de General de Sierrallana y Tres Mares, Spain 4Interventional Cardiology, Med Star Washington Hospital Center, USA 5Department of Cardiovascular Surgery, Marqués de Valdecilla University Hospital, Spain 6Service of Infectious Diseases, Marqués de Valdecilla University Hospital, Spain

*Correspondance to: Andrea Teira CalderĂ³n 

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Abstract

Background: Infections are frequent and particularly serious complications of the implantation of ventricular assist devices for the treatment of heart failure, Gordonia species have recently been found to cause human infections. Specifically, Gordonia bronchialis has been associated with sternal wound infection. Methods: The present is the first case of VAD-associated mediastinitis by Gordonia bronchialis. A review of previously reported cases of Gordonia spp. infections was performed. Relevant clinical and epidemiological features were summarized. Results: A 49-year-old patient had a history of end-stage ischemic cardiomyopathy and severe pulmonary hypertension that precluded heart transplantation. A VAD was implanted as a bridge to candidacy. Recourse was complicated due to the development of mediastinitis secondary to Gordonia bronchialis. A total of 69 cases of Gordonia spp. infections have been reported. The most frequently isolated species was G. bronquialis (40.58%). Main risk factors were immunosuppression and patients harboring devices. The most frequent presentation was skin infection (30.43%). Most of the cases required further diagnostic testing in addition to a culture to achieve the diagnosis (78.26%). Antibiotic regimens were heterogeneous. The prognosis was favorable. Conclusions: Gordonia spp. are rare but emergent pathogens which have been associated with the implanted devices and immunosuppression. Low mortality and morbidity have been reported.  

Keywords:

Gordonia; Mediastinitis; Ventricular Assist Device (VAD)

Citation:

Calderón AT, Cobo RT, Levine MB, Cobo M, Castrillo C, Burgos V, et al. First Case of VAD-Associated Mediastinitis by Gordonia bronchialis: A Case Report and a Review of an Emergent Pathogen. Am J Clin Microbiol Antimicrob. 2023; 6(1): 1065..

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